This is in part, once again, because of the perception of hyper-fertility among Black women who often get surgical sterilization after having children in their 20s, says Kudesia. But counseling sterilization has a loaded history in the US, where it was historically used to control the Black population, at times with racist intent and at others, with the support of Black intellectuals, with the belief it would be a tool of empowerment. Black women were counseled toward ligation more frequently, out of the belief their supposed hyper-fertility would be socially and economically damaging.

As a result of this history, ligation is so prevalent among Black women that it’s often the default contraceptive method they turn to. Yet in many cases, these women lack a complete and clear understanding of the consequences of tubal ligation. A 2014 study found that 62% of African American women think fertility is easily restored after tubal ligation (32% of white women thought so) and 60% thought tubal sterilization would reverse after five years (compared to 23% white women). In reality, while reversal is possible in some cases, the procedure is by-and-large permanent.

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